Zope Manali, Hocking Matthew C
The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA, USA.
J Clin Psychol Med Settings. 2025 Jun;32(2):297-305. doi: 10.1007/s10880-024-10059-9. Epub 2024 Dec 4.
For pediatric cancer survivors in the post-treatment, school-reintegration period, integrating multi-informant reports and promoting a mutual clinician-family-school understanding of the child's needs are critical for comprehensive care. This study evaluated patterns of agreement between child, parent, and teacher reports of psychosocial functioning in pediatric brain tumor survivors (PBTS) and non-CNS solid tumor survivors (PSTS).
PBTS (n = 51) and PSTS (n = 34) age 7-14 who received tumor-directed therapy completed the study. Parents and teachers completed the CBCL/TRF and SSIS, and parents and children completed the PedsQL and PROMIS peer relationships. Intra-class correlation coefficients, % disagreements, t-tests, and correlations quantified inter-rater agreement.
Analysis yielded poor-to-moderate ICC levels across measures. Parent-teacher agreement was higher for reports of externalizing symptoms. Parents had higher ratings of child-internalizing problems, but lower ratings of overall social skills than teacher ratings. Parents had higher ratings of child emotional functioning and social skills compared to self-reports.
Findings underscore the necessity for integrating multi-informant reports of psychosocial functioning in assessment for pediatric cancer survivors. Findings also highlight critical gaps in mutual parent-teacher-child understanding, indicating the need for increased collaboration in the post-treatment period.
对于处于治疗后重返学校阶段的儿科癌症幸存者而言，整合多渠道信息报告并促进临床医生、家庭和学校对儿童需求的相互理解对于全面护理至关重要。本研究评估了儿童、家长和教师对小儿脑肿瘤幸存者（PBTS）和非中枢神经系统实体瘤幸存者（PSTS）心理社会功能报告的一致性模式。
7至14岁接受肿瘤定向治疗的PBTS（n = 51）和PSTS（n = 34）完成了本研究。家长和教师完成了儿童行为量表/青少年自评量表（CBCL/TRF）和社会技能评定量表（SSIS），家长和儿童完成了儿童生活质量量表（PedsQL）和患者报告结果测量信息系统（PROMIS）同伴关系量表。组内相关系数、不一致百分比、t检验和相关性对评分者间的一致性进行了量化。
各项测量的组内相关系数水平为低到中等。外化症状报告的家长-教师一致性较高。家长对儿童内化问题的评分较高，但对总体社交技能的评分低于教师评分。与自我报告相比，家长对儿童情绪功能和社交技能的评分较高。
研究结果强调了在评估儿科癌症幸存者时整合心理社会功能多渠道信息报告的必要性。研究结果还凸显了家长、教师和儿童之间相互理解方面的关键差距，表明在治疗后阶段需要加强合作。
